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14-September-2008 18:38:51 - Abdominoperineal resection Redirected from Abdominoperineal excision Abdominoperineal resection. Abdominoperineal resection. An abdominoperineal resection, formally known as abdominoperineal resection of the rectum and abdominoperineal excision of the rectum or simply abdominoperineal excision, is a surgery for rectal cancer. It is frequently abbreviated as AP resection and APR. Contents 1 Indication and description 2 Centralisation of rectal surgery 3 Relation to anterior resection 4 See also 5 References Indication and description The principal indication for AP resection is a rectal carcinoma situated in the lower third of the rectum. Other indications include recurrent or residual anal carcinoma squamous cell carcinoma following initial, usually definitive combination chemoradiotherapy. APRs involves removal of the anus, the rectum and part of the sigmoid colon along with the associated regional lymph nodes, through incisions made in the abdomen and perineum. The end of the remaining sigmoid colon is brought out permanently as an opening, called a colostomy, on the surface of the abdomen. Centralisation of rectal surgery This operation is one of the less commonly performed by general surgeons, although they are specifically trained to perform this operation. As low case volumes in rectal surgery have been found to be associated with higher complication rates,12 it is often centralised in larger centres,3 where case volumes are higher. Relation to anterior resection An APR, generally, results in a worse quality of life than the less invasive lower anterior resection.45 Thus, LARs are generally the preferred treatment for rectal cancer insofar as this is surgically feasible. APRs are the preferred operation for cancer in the distal one-third of the rectum.6 See also Stoma medicine References ^ Schrag D, Panageas KS, Riedel E, et al November 2002. Hospital and surgeon procedure volume as predictors of outcome following rectal cancer resection. Ann. Surg. 236 5: 583-92. doi:10.1097/01.SLA.0000033036.14533.BC inactive 2008-06-22. PMID 12409664. ^ Marusch F, Koch A, Schmidt U, Pross M, Gastinger I, Lippert H October 2001. Hospital caseload and the results achieved in patients with rectal cancer. Br J Surg 88 10: 1397-402. doi:10.1046/j.0007-1323.2001.01873.x. PMID 11578299. ^ Martling A, Holm T, Cedermark B 2005. Skills by training. Education and case volume are strong prognostic factors in rectal cancer surgery in Swedish. Lakartidningen 102 6: 374-6. PMID 15754678. ^ McLeod RS 2001. Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer. Ann. Surg. 233 2: 157-8. doi:10.1097/00000658-200102000-00002. PMID 11176119. ^ Grumann MM, Noack EM, Hoffmann IA, Schlag PM 2001. Comparison of quality of life in patients undergoing abdominoperineal extirpation or anterior resection for rectal cancer. Ann. Surg. 233 2: 149-56. doi:10.1097/00000658-200102000-00001. PMID 11176118. ^ American Cancer Society. Detailed Guide: Colon and Rectum Cancer. cancer.org. URL: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4x_Surgery_10.asp?sitearea=. Accessed on: February 5, 2008. v d e Health science - Surgery - General surgery neck Resection Thyroid cancer, Lymphoma esophagus - stomach Resection Esophageal cancer, Stomach cancer, Bariatric surgery Morbid obesity, Repair Trauma abdomen non-GI Kidney transplant Chronic renal failure, Resection Kidney cancer, Metastatic disease, Debulking surgery Ovarian cancer, Hernia repair liver - pancreas gallbladder - biliary tree Liver transplant Hepatitis, Cirrhosis, PBC, PSC, Resection HCC, Metastatic disease of the liver, Resection Whipple procedure Pancreatic cancer, Cholecystectomy Cholecystitis small intestine Resection due to bowel infarction and/or small bowel obstruction - Intussusception, Volvulus, Crohn's disease, Meckel's diverticulum, Meconium ileus due to Cystic fibrosis, Cancer of the small bowel colon Appendectomy Appendicitis, Resection Lower anterior resection, Abdominoperineal resection, Hemicolectomy, Total colectomy, Local excision due to obstruction and/or perforation/threatened perforation and/or malignancy Toxic megacolon due to IBD, Colon cancer, Rectal cancer, Hirschsprung's disease, Trauma, Intussusception, Volvulus, Inguinal hernia, Adhesions due to previous surgery This surgery article is a stub. Retrieved from http://en..org/wiki/Abdominoperineal_resection Categories: General surgery | Surgery stubsHidden category: Pages with DOIs broken since 2008 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages العربية This page was last modified on 22 June 2008, at 17:22
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